Comparing the clinical utility of single-shot echo-planar imaging and readout-segmented echo-planar imaging in diffusion-weighted imaging of the liver at 3 tesla. Issue 135 (February 2021)

• Record Type: Journal Article
• Authors: Xie, Simin; Masokano, Ismail Bilal; Liu, Wenguang; Long, Xueying; Li, Guijin; Pei, Yigang; Li, Wenzheng
• Is Part Of: European journal of radiology. Issue 135(2021)
• Publication Date: 2021-02
• Subjects: DC apparent diffusion coefficient -- SNR signal-to-noise ratio -- SS-EPI single-shot echo-planar imaging -- BH breath-hold -- RT respiratory-triggering -- NT navigator-triggering -- RS-EPI Readout-segmented echo-planar imaging -- MPR multiplanar reconstruction; Hepatic diffusion-weighted imaging -- Single-shot echo-planar imaging (EPI) -- Readout-segmented EPI -- NT-DWI -- Clinical utility; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109472
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: SS-EPI sequence showed superior ADC repeatability than RS-EPI in liver diffusion studies. Navigator triggered SS-EPI has the best ADC repeatability. The navigator triggered SS-EPI can produce DW images with sufficient SNR and excellent image quality. Navigator triggered SS-EPI is the optimal technique for the evaluation of liver diseases in clinical practice. The central section of the right liver lobe is less affected my physiologic motion. Abstract: Purpose: To compare the clinical utility of single-shot echo-planar imaging (SS-EPI) using different breathing schemes and readout-segmented EPI (RS-EPI) in the repeatability of apparent diffusion coefficient (ADC) measurements, signal-to-noise ratio (SNR) and image quality. Methods: In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mm 2 ) were performed in 22 volunteers on 3.0 T MRI using SS-EPI with free-breathing diffusion-weighted imaging (FB-DWI), breath-hold (BH-DWI), respiratory-triggered (RT-DWI) and navigator-triggered (NT-DWI), and readout-segmented EPI (RS-DWI). ADC and surrogate SNR (sSNR) were measured in nine anatomic locations in the right lobe, and image quality was assessed on all FB-DWI, BH-DWI, RT-DWI, NT-DWI, and RS-DWI sequences. The sequence with the optimal clinical utility was decided by systematically comparing the ADC repeatability, sSNR and image quality of the above DWIs. Results: In all the five sequences, NT-DWI had the most reliable intra-observer agreement (intraclass correlation coefficient (ICC): 0.900−0.922; all P > 0.05), and a better interobserver agreement (ICC: 0.853−0.960; all p > 0.05) than RS-DWI (ICC:0.881−0.916; some P < 0.05). NT-DWI had the best ADC repeatability in the nine locations (mean ADC absolute differences: 38.47–56.38 × 10 −6 mm 2 /s, limits of agreement (LOA): 17.33–22.52 × 10 −6 mm 2 /s). Also, NT-DWI had the highest sSNR (Reader 1: 50.58 ± 20.11 (Superior), 74.06 ± 28.37 (Central), 80.99 ± 38.11(Inferior)); Reader 2: 48.07 ± 23.92 (Superior), 68.23 ± 32.91 (Central), 76.78 ± 33.07 (Inferior)) in three representative sections except for RS-DWI. Furthermore, NT-DWI had a better image quality than RS-DWI (P < 0.05) and was superior to FB-DWI and BH-DWI in sharpness of the liver (at b = 300 s/mm 2 ) (P < 0.05) Conclusion: RS-DWI has the best SNR. However, NT-DWI can provide sufficient SNR, excellent image quality, and the best ADC repeatability on 3.0 T MRI. It is thus the recommended sequence for the clinical application of hepatic DWI.